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Citizen science has been particularly effective in gathering reliable, timely, large-scale data on the presence and distributions of animal species, including mosquito vectors of human and zoonotic pathogens. This involves the participation of citizen scientists in research projects, with success strongly dependent on the capacity to disseminate project information and engage citizen scientists to contribute their time. Mosquito Alert is a citizen science that aids in the system surveillances of vector mosquitoes. It involves citizen scientists providing expert-validated photos of targeted mosquitoes, along with records of bites and breeding sites. Since 2020 the system has been disseminated throughout Europe. This article uses models to analyze the effect of promotion activities carried out by the Mosquito Alert ITALIA team from October 2020 to December 2022 on the number of citizen scientists recruited and engaged in the project, and their performance in mosquito identification. Results show a high level of citizen scientist recruitment (N > 18.000; 37 % of overall European participants). This was achieved mostly through articles generated by ad hoc press releases detailing the app's goals and functioning. Press releases were more effective when carried out at the beginning and end of the mosquito season and when mosquito's public health significance was emphasized. Despite the high number of records received (N > 20.000), only 30 % of registered participants sent records, and the probability of a participant sending a record dropped off quickly over time after first registering. Among participants who contributed, â¼50 % sent 1 record, â¼30 % ≥3 and 4 % >10 records. Participants showed good capacity to identify mosquitoes and improve identification skills with app usage. The results will be valuable for anyone interested in evaluating citizen science, as participation and engagement are seldom quantitatively assessed. Our results are also useful for designing dissemination and education strategies in citizen science projects associated with arthropod vector monitoring.
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Ciência do Cidadão , Mosquitos Vetores , Zoonoses , Itália , Animais , Humanos , Vetores Artrópodes , Culicidae , Controle de Mosquitos/métodosRESUMO
PURPOSE: Significant heterogeneity exists in clinical quality assurance (QA) practices within radiation oncology departments, with most chart rounds lacking prospective peer-reviewed contour evaluation. This has the potential to significantly affect patient outcomes, particularly for head and neck cancers (HNC) given the large variance in target volume delineation. With this understanding, we incorporated a prospective systematic peer contour-review process into our workflow for all patients with HNC. This study aims to assess the effectiveness of implementing prospective peer review into practice for our National Cancer Institute Designated Cancer Center and to report factors associated with contour modifications. METHODS AND MATERIALS: Starting in November 2020, our department adopted a systematic QA process with real-time metrics, in which contours for all patients with HNC treated with radiation therapy were prospectively peer reviewed and graded. Contours were graded with green (unnecessary), yellow (minor), or red (major) colors based on the degree of peer-recommended modifications. Contours from November 2020 through September 2021 were included for analysis. RESULTS: Three hundred sixty contours were included. Contour grades were made up of 89.7% green, 8.9% yellow, and 1.4% red grades. Physicians with >12 months of clinical experience were less likely to have contour changes requested than those with <12 months (8.3% vs 40.9%; P < .001). Contour grades were significantly associated with physician case load, with physicians presenting more than the median number of 50 cases having significantly less modifications requested than those presenting <50 (6.7% vs 13.3%; P = .013). Physicians working with a resident or fellow were less likely to have contour changes requested than those without a trainee (5.2% vs 12.6%; P = .039). Frequency of major modification requests significantly decreased over time after adoption of prospective peer contour review, with no red grades occurring >6 months after adoption. CONCLUSIONS: This study highlights the importance of prospective peer contour-review implementation into systematic clinical QA processes for HNC. Physician experience proved to be the highest predictor of approved contours. A growth curve was demonstrated, with major modifications declining after prospective contour review implementation. Even within a high-volume academic practice with subspecialist attendings, >10% of patients had contour changes made as a direct result of prospective peer review.
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Neoplasias de Cabeça e Pescoço , Garantia da Qualidade dos Cuidados de Saúde , Humanos , Neoplasias de Cabeça e Pescoço/radioterapia , Garantia da Qualidade dos Cuidados de Saúde/normas , Planejamento da Radioterapia Assistida por Computador/métodos , Planejamento da Radioterapia Assistida por Computador/normas , Estudos Prospectivos , Feminino , Radioterapia (Especialidade)/normas , Radioterapia (Especialidade)/métodos , MasculinoRESUMO
BACKGROUND: In this study, we identified key discrete clinical and technical factors that may correlate with primary reconstructive success in endoscopic skull base surgery (ESBS). METHODS: ESBS cases with intraoperative cerebrospinal fluid (CSF) leaks at four tertiary academic rhinology programs were retrospectively reviewed. Logistic regression identified factors associated with surgical outcomes by defect subsite (anterior cranial fossa [ACF], suprasellar [SS], purely sellar, posterior cranial fossa [PCF]). RESULTS: Of 706 patients (50.4% female), 61.9% had pituitary adenomas, 73.4% had sellar or SS defects, and 20.5% had high-flow intraoperative CSF leaks. The postoperative CSF leak rate was 7.8%. Larger defect size predicted ACF postoperative leaks; use of rigid reconstruction and older age protected against sellar postoperative leaks; and use of dural sealants compared to fibrin glue protected against PCF postoperative leaks. SS postoperative leaks occurred less frequently with the use of dural onlay. Body-mass index, intraoperative CSF leak flow rate, and the use of lumbar drain were not significantly associated with postoperative CSF leak. Meningitis was associated with larger tumors in ACF defects, nondissolvable nasal packing in SS defects, and high-flow intraoperative leaks in PCF defects. Sinus infections were more common in sellar defects with synthetic grafts and nondissolvable nasal packing. CONCLUSIONS: Depending on defect subsite, reconstructive success following ESBS may be influenced by factors, such as age, defect size, and the use of rigid reconstruction, dural onlay, and tissue sealants.
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Vazamento de Líquido Cefalorraquidiano , Endoscopia , Procedimentos de Cirurgia Plástica , Base do Crânio , Humanos , Feminino , Masculino , Base do Crânio/cirurgia , Vazamento de Líquido Cefalorraquidiano/etiologia , Vazamento de Líquido Cefalorraquidiano/prevenção & controle , Vazamento de Líquido Cefalorraquidiano/epidemiologia , Estudos Retrospectivos , Pessoa de Meia-Idade , Endoscopia/métodos , Procedimentos de Cirurgia Plástica/métodos , Adulto , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/epidemiologia , Idoso , Neoplasias Hipofisárias/cirurgia , Neoplasias da Base do Crânio/cirurgia , Rinorreia de Líquido Cefalorraquidiano/prevenção & controle , Rinorreia de Líquido Cefalorraquidiano/cirurgia , Rinorreia de Líquido Cefalorraquidiano/etiologiaRESUMO
Introducción: La administración organizacional en salud busca garantizar una atención efectiva y una gestión eficiente; evalúa la atención y satisfacción que a su vez guardan una estrecha y compleja relación. Objetivo: Estimar la asociación entre la calidad de atención y la satisfacción del usuario externo, del servicio de laboratorio clínico. Métodos: Estudio cuantitativo, correlacional, de diseño observacional transversal. La población estudiada fueron usuarios atendidos en el servicio de laboratorio clínico de un hospital privado, en Lima, Perú, a quienes se les aplicó un cuestionario de elaboración propia sobre calidad de atención y otro de satisfacción del usuario adaptado del modelo SERVPERF. La información obtenida fue analizada con el software IBM SPSS Statistics 23.0 y para la prueba de hipótesis se aplicó el coeficiente de correlación de Spearman. Resultados: De los 220 usuarios encuestados, el 69,1 por ciento calificó como alta la calidad brindada, en la cual la dimensión mejor calificada fue la calidad humana (71,8 por ciento); asimismo, el 73,6 por ciento de los usuarios afirmaron estar satisfechos y dentro de ello, las dimensiones con mayor satisfacción fueron la empatía (73,2 por ciento) y la seguridad (73,1 por ciento). Conclusiones: La calidad de atención y sus dimensiones que la conforman se asocian con la satisfacción de los usuarios(AU)
Introduction: The healthcare management seeks to guarantee effective care and efficient management, assesses care and satisfaction, which in turn have a close and complex relationship. Objective: To estimate the association between the quality of care and the satisfaction of the external user of the clinical laboratory service. Methods: Quantitative, correlational study, with a cross-sectional observational design. The population studied were users treated in the clinical laboratory service of a private hospital in Lima, Peru, to whom a self-developed questionnaire was applied on quality of care and another on user satisfaction adapted from the SERVPERF model. The information obtained was analyzed with the IBM SPSS Statistics 23.0 software and Spearman's correlation coefficient was applied for the hypothesis test. Results: Of the 220 users surveyed, 69.1 percent rated the quality provided as high, in which the best rated dimension was human quality (71.8 percent ); Likewise, 73.6 percent of the users stated that they were satisfied and within this, the dimensions with the greatest satisfaction were empathy (73.2 percent ) and security (73.1 percent). Conclusions: The quality of care and its dimensions that make it up are associated with user satisfaction(AU)
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde/organização & administração , Avaliação de Processos em Cuidados de Saúde/métodos , Satisfação do Paciente , Serviços de Laboratório Clínico/organização & administração , Estudos Transversais , Hospitais Privados , Pesquisas sobre Atenção à Saúde/métodos , Estudos Observacionais como Assunto , Estudos de Avaliação como AssuntoRESUMO
Hypertension is the leading preventable risk factor for cardiovascular disease and all-cause mortality worldwide. However, studies have shown increased risk of mortality from heart disease and stroke even within the normal blood pressure (BP) range, starting at BPs above 110-115/70-75 mm Hg. Nutraceuticals, such as vitamins and minerals, have been studied extensively for their efficacy in lowering BP and may be of benefit to the general, normotensive population in achieving optimal BP. Our study investigated the effects of six nutraceuticals (Vitamins: C, D, E; Minerals: Calcium, Magnesium, Potassium) on both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in this population. We performed a systematic review and pairwise meta-analysis for all six supplements versus placebo. Calcium and magnesium achieved significant reductions in both SBP and DBP of -1.37/-1.63 mm Hg and -2.79/-1.56 mm Hg, respectively. Vitamin E and potassium only yielded significant reductions in SBP with values of -1.76 mm Hg and -2.10 mm Hg, respectively. Vitamins C and D were not found to significantly lower either SBP or DBP. Future studies should determine optimal dosage and treatment length for these supplements in the general, normotensive population.
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Hipertensão , Hipotensão , Humanos , Vitaminas , Pressão Sanguínea , Magnésio/farmacologia , Magnésio/uso terapêutico , Cálcio/farmacologia , Suplementos Nutricionais , Hipertensão/epidemiologia , Minerais/farmacologia , Minerais/uso terapêutico , Hipotensão/tratamento farmacológico , Cálcio da Dieta/farmacologia , Potássio/farmacologia , Anti-Hipertensivos/farmacologiaRESUMO
Introducción: La investigación en pregrado se ha convertido en una parte integral de la formación médica, la cual ha transformado a la educación en salud y ha seguido históricamente un modelo estático con una orientación hospitalaria. Objetivo: Determinar los factores asociados al dominio correspondiente a docencia e investigación, en las mallas curriculares de las facultades de medicina humana de universidades peruanas. Métodos: Estudio de corte transversal en el cual se analizaron las mallas curriculares de las facultades de medicina humana existentes en Perú en el año 2022. Se seleccionaron asignaturas que cumplieron las características correspondientes al dominio Docencia e Investigación según lo establecido en el Documento Técnico del Ministerio de Salud. Asimismo, se evaluaron las variables tipo de universidad, ubicación, año de creación; también se recopilaron variables relacionadas con investigación: ranking SIR IBER 2022, número de publicaciones generales en Scopus, número de publicaciones en medicina en Scopus, índice H Scopus y número de investigadores. Resultados: De 40 facultades de medicina humana, la media de cursos del dominio Docencia e Investigación fue de 6,5. Se encontró que el tipo de universidad tuvo asociación significativa con la frecuencia de cursos correspondientes al dominio Docencia e Investigación, con una media de cursos en universidades privadas superior a la media reportada en universidades públicas ( = 7,5 vs. = 5,5; p = 0,023). Conclusiones: El factor asociado al dominio correspondiente Docencia e Investigación es el tipo de universidad, se encuentra una media de cursos en universidades privadas superior a lo reportado en universidades públicas.
Introduction: Undergraduate research has become an integral part of medical education which has transformed health education, and has historically followed a static model with a hospital orientation. Objective: To determine the factors associated to the domain teaching and research in the curricula of the faculties of human medicine of Peruvian universities. Methods: Cross-sectional study where the curricula of the faculties of human medicine existing in Peru by the year 2022 were analyzed. Subjects that met the characteristics corresponding to the Teaching and Research domain were selected as established in the Technical Document of the Ministry of health. Likewise, variables such as the type of university, location, year of creation were evaluated; Variables related to research were also collected, such as SIR IBER 2022 ranking, number of general publications in Scopus, number of medical publications in Scopus, Scopus H index and number of researchers. Results: Of 40 faculties of human medicine, the average number of Teaching and Research domain courses was 6,5. It was found that the type of university had a significant association with the frequency of courses corresponding to the Teaching and Research domain, with a mean number of courses in private universities higher than the mean reported in public universities ( = 7,5 vs. = 5,5; p = 0,023). Conclusions: The factor associated to the Teaching and Research domain was the type of university, it was found an average of courses in private universities higher than that reported in public universities.
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Introducción: La familia representa el entorno más cercano al paciente y por ello, la funcionalidad familiar es el soporte más importante, pues con ello el paciente logra una óptima adherencia al tratamiento de enfermedades crónicas, entre ellas, la diabetes. Objetivo: Determinar la frecuencia y asociación entre la funcionalidad familiar y la adherencia al tratamiento de la diabetes en pacientes atendidos en el programa de pacientes crónicos en un establecimiento de salud de atención primaria de Lima. Métodos: Estudio transversal realizado en 2020. Se recopiló información sobre la adherencia al tratamiento y la funcionalidad familiar de los pacientes. Se midieron variables sociodemográficas y variables relacionadas a la diabetes. Se realizó un análisis de regresión simple y múltiple para estimar la asociación entre la adherencia al tratamiento y la funcionalidad familiar y variables sociodemográficas. Resultados: El 71,6 % de encuestados fueron mujeres. El 78,4 % de los pacientes presentaron alguna comorbilidad, el promedio de hemoglobina glicosilada de los encuestados fue de 8,9 %. Se encontró que el 59,7 % de pacientes perteneció a una familia disfuncional y el 87,3 % no cumplió de forma óptima con el tratamiento para su enfermedad. En el análisis bivariado se encontró asociación significativa entre la funcionalidad familiar y la adherencia al tratamiento (p= 0,028). En el análisis de regresión múltiple, se mantuvo la asociación (RP= 2,78, IC95 %: 1,13-6,83). Conclusiones: La frecuencia de una mala adherencia al tratamiento en pacientes diabéticos es alta. La funcionalidad familiar está asociada a la adherencia al tratamiento farmacológico.
Introduction: The family represents the closest environment to the patient and for this reason, family functionality is the most important support because with it the patient achieves optimal adherence to the treatment of chronic diseases, including diabetes. Objective: To determine the relationship between family functionality and adherence to diabetes treatment in patients treated in the chronic patients' program in a primary care health facility in Lima. Methods: Cross-sectional study carried out in 2020. Information was collected on adherence to treatment and family functionality of the patients. Likewise, sociodemographic variables and variables related to diabetes were measured. A simple and multiple regression analysis were performed to estimate the association between adherence to treatment and the sociodemographic variables. Results: 71.6% of respondents were women. 78.4% of the patients reported having some comorbidity. In addition, the average glycated hemoglobin of the respondents was 8.9%. It was found that 59.7% of patients belonged to a dysfunctional family and 87.3% did not optimally comply with the treatment for their disease. In the bivariate analysis, a significant association was found between family functionality and adherence to treatment (p= 0.028). In the multiple regression analysis, the association was maintained (PR= 2.73, 95% CI: 1.08-6.87). Conclusions: The frequency of poor adherence to treatment in diabetic patients is high. Family functionality is associated with adherence to drug treatment.
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Introducción: Existe evidencia sobre el efecto negativo del uso de tecnologías de información y comunicación en estudiantes, sin embargo, poco se conoce sobre problemas fisioergonómicos secundarios a su uso. Objetivo: Identificar los factores tecnológicos-educativos asociados al reporte de 4 problemas fisioergonómicos en estudiantes de medicina. Métodos: Estudio transversal en estudiantes de medicina de 11 países de Latinoamérica y el Caribe. Se utilizó un cuestionario cuyas variables fueron las características socio-educativas y tecnológicas, así como los problemas fisioergonómicos (dolor de cuello, dolor de espalda, ojo seco/rojo y dolor de cabeza). Resultados: De 11 587 estudiantes, 14,5 % reportó presentar 4 problemas fisioergonómicos. La mayoría reportó dolor de cuello (50 %), dolor de espalda (50,5 %) y dolor de cabeza (53,7 %). Tuvieron mayor frecuencia de presentar estos problemas fisioergonómicos las mujeres (RP= 1,06), quienes estudiaron una carrera previa (RP= 1,19), pertenecer a todos los años de estudios (RP= 1,12-1,20), quienes tenían mayor uso de Internet en horas (RP= 1,01) y aquellos que accedían a Twitter en horas de clases (RP= 1,30). La frecuencia de presentar estos problemas disminuyó en quienes tenían menor edad en años (RP= 0,99), procedían de una universidad privada (RP= 0,81), y quienes pertenecían a cualquier grupo extracurricular (RP= 0,67-0,93). Conclusiones: Los factores tecnológicos-educativos asociados al reporte de 4 problemas fisioergonómicos en estudiantes de medicina son ser mujer, tener carrera previa, pertenecer a todos los años de estudios, horas de uso de internet y el acceso a Twitter durante clases.
Introduction: There is evidence on the negative effect of the use of information and communication technologies on students, however, little is known about physio-ergonomic problems secondary to their use. Objective: To identify the technological-educational factors associated with the report of 4 physio-ergonomic problems in medical students. Methods: Cross-sectional study in medical students from 11 countries in Latin America and the Caribbean. A questionnaire was used whose variables were socio-educational and technological characteristics, as well as physio-ergonomic problems (neck pain, back pain, dry/red eye and headache). Results: Of 11 587 students, 14.5% reported presenting 4 physio-ergonomic problems. Most reported neck pain (50%), back pain (50.5%), and headache (53.7%). Women (PR= 1.06), who studied a previous degree (PR= 1.19), who belonged to all years of studies (PR= 1.12-1.20), who had greater use of the Internet, had a higher frequency (in hours) of presenting these physio-ergonomic problems (PR= 1.01) and those who accessed Twitter during school hours (PR= 1.30). They decreased the frequency of presenting these problems, being younger in years (PR= 0.99), coming from a private university (PR= 0.81), and who belonged to any extracurricular group (PR= 0.67-0.93). Conclusions: The technological-educational factors associated with the report of 4 physio-ergonomic problems in medical students were being a woman, having a previous degree, belonging to all the years of study, hours of Internet use and access to Twitter during classes.
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Introducción: La funcionalidad familiar influye en el proceso salud-enfermedad, es por ello que se destaca su importancia en el primer nivel de atención. No existe evidencia concluyente sobre los factores que influyen en la disfunción familiar en pacientes atendidos en el primer nivel de atención. Objetivo: Determinar la prevalencia y factores asociados a disfunción familiar en pacientes atendidos en el primer nivel de atención. Métodos: Estudio transversal de análisis secundario de datos en pacientes atendidos en 7 establecimientos del primer nivel de atención de Lima, Perú, en 2019. Se utilizó el cuestionario Apgar Familiar y se indagó su asociación con factores demográficos-socioeconómicos. Se estimaron razones de prevalencia (RP) a través de modelos de regresión simple y múltiple. Resultados: De 150 pacientes, la mayoría fueron mujeres (81,3 %) y la mediana de edad fue de 32 años. El 14 % presentó disfunción familiar. Los pacientes con acceso a servicio de agua tenían menor prevalencia de disfunción familiar (RP: 0,04; IC95 %: 0,001 - 0,47). Residir entre 1 a 10 años en Lima representó menor prevalencia de disfunción familiar; en comparación con pacientes recién llegados a la capital (menos de 1 año) (RP: 0,15; IC95 %: 0,04 - 0,62). Conclusiones: La prevalencia de disfunción familiar en pacientes atendidos en primer nivel de atención es baja. Tener acceso a servicio de agua y residir entre 1 a 10 años en la capital influyó en una menor prevalencia de disfunción familiar.
Introduction: Family functionality influences the health-disease process, which is why its importance in the first level of care is highlighted. There is no conclusive evidence on the factors that influence family dysfunction in patients treated at the First Level of Care. Objective: To determine the prevalence and factors associated with family dysfunction in patients treated at the First Level of Care. Methods: Cross-sectional study of secondary data analysis in patients treated in 7 primary care establishments in Lima, Peru in 2019. The Family Apgar questionnaire was used, and its association with demographic-socioeconomic factors was investigated. Prevalence ratios (PR) were estimated through simple and multiple regression models. Results: Of 150 patients, the majority were women (81.3%) and the median age was 32 years. 14% presented family dysfunction. Patients with access to water service had a lower prevalence of family dysfunction (PR: 0.04; 95% CI: 0.001-0.47). Living between 1 and 10 years in Lima represented a lower prevalence of family dysfunction; compared with patients recently arrived in the capital (less than 1 year) (PR: 0.15; 95% CI: 0.04- 0.62). Conclusions: The prevalence of family dysfunction in patients treated at the primary care level was low. Having access to water service and residing between 1 and 10 years in the capital influenced a lower prevalence of family dysfunction.
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During medical training, students are exposed to stressors that deteriorate mental health. This study determined depression and anxiety prevalence and their associated factors in students from four medical schools in northern Peru. A cross-sectional study was conducted among medical students from Lambayeque, Peru. The Goldberg Anxiety and Zung Depression tests were applied. The dependent variables were depression and anxiety, and their association with covariates (age, sex, type of university, socioeconomic level, experience, family problem, and physical activity) was evaluated. Prevalence ratios were calculated using generalized linear models. Of 482 students, the prevalence of anxiety was 61.8% and depression was 22.0%. A severe level of anxiety was observed in 6.2% in the group between 16 and 20 years old. It was observed that private university students had higher frequencies of having depression (PR = 2.01) and anxiety (PR = 1.35); males had a lower risk of anxiety (PR = 0.82), but higher risk of depression compared to females (PR = 1.45). Performing physical activity decreased the prevalence of depression (PR = 0.53); however, it increased the frequency of anxiety (PR = 1.26). Having family problems increased the prevalence of anxiety (PR = 1.26). Medical students from private universities experienced higher rates of depression and anxiety. Depression and anxiety were associated with gender and physical activity. These findings highlight the importance of mental health promotion due to its link with quality of life and academic performance.
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Estudantes de Medicina , Masculino , Feminino , Humanos , Adolescente , Adulto Jovem , Adulto , Estudantes de Medicina/psicologia , Peru , Prevalência , Estudos Transversais , Depressão/epidemiologia , Qualidade de Vida , Ansiedade/epidemiologia , UniversidadesRESUMO
Patients with persistent orofacial pain (POFP) can go through complex care pathways to receive a diagnosis and management, which can negatively affect their pain. This study aimed to describe 44-y trends in attendances at Welsh medical practices for POFP and establish the number of attendances per patient and referrals associated with orofacial pain and factors that may predict whether a patient is referred. A retrospective observational study was completed using the nationwide Secure Anonymised Information Linkage Databank of visits to general medical practices in Wales (UK). Data were extracted using diagnostic codes ("Read codes"). Orofacial and migraine Read codes were extracted between 1974 and 2017. Data were analyzed using descriptive statistics and univariate and multivariable logistic regression. Over the 44-y period, there were 468,827 POFP and migraine diagnostic codes, accounting for 468,137 patient attendances, or 301,832 patients. The overall attendance rate was 4.22 attendances per 1,000 patient-years (95% confidence interval [CI], 4.21-4.23). The attendance rate increased over the study period. Almost one-third of patients (n = 92,192, 30.54%) attended more than once over the study period, and 15.83% attended more than once within a 12-mo period. There were 20,103 referral codes that were associated with 8,183 patients, with over half these patients being referred more than once. Odds of receiving a referral were highest in females (odds ratio [OR], 1.23; 95% CI, 1.17-1.29), in those living in rural locations (OR, 1.17; 95% CI, 1.12-1.22), and in the least deprived quintile (OR, 1.39; 95% CI, 1.29-1.48). Odds also increased with increasing age (OR, 1.03; 95% CI, 1.03-1.03). The increasing attendance may be explained by the increasing incidence of POFP within the population. These patients can attend on a repeated basis, and very few are referred, but when they are, this may occur multiple times; therefore, current care pathways could be improved.
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Dor Facial , Transtornos de Enxaqueca , Feminino , Humanos , Dor Facial/diagnóstico , Dor Facial/epidemiologia , Estudos RetrospectivosRESUMO
During the COVID-19 pandemic, university students have adopted measures that completely transformed their educational environment, and this has generated an increase in psychological stress. The present study aimed to identify the factors associated with anxiety, depression, and stress in students at a university in Peru during the COVID-19 pandemic in 2020. We conducted a cross-sectional analytical study in students in Lima, Peru. The DASS-21 scale was used to measure levels of depression, anxiety, and stress and associate it with socio-educational and COVID-19-related variables using generalized linear models with Poisson distribution, log link, and robust variance. Of 400 students surveyed, 19.2%, 23.2% and 17.2% of students presented depression, anxiety, and stress, respectively. The frequency of depression (PR = 0.91, 95%CI: 0.84-0.99), anxiety (PR = 0.90, 95%CI: 0.83-0.99) and stress (PR = 0.92, 95%CI: 0.86-0.99) was lower in women. The students of the engineering and business faculty presented a higher frequency of anxiety (PR = 1.11, 95%CI: 1.00-1.22). There was a greater frequency of presenting anxiety, depression and stress in students who worked in a different area of health or did not work. Our results suggest the importance of promoting mental health awareness campaigns in university students due to the constant academic load they have.
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COVID-19 , Feminino , Humanos , COVID-19/epidemiologia , Pandemias , Peru/epidemiologia , Universidades , Depressão/epidemiologia , Depressão/psicologia , SARS-CoV-2 , Estudos Transversais , Saúde Mental , Ansiedade/epidemiologia , Ansiedade/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Estudantes/psicologiaRESUMO
BACKGROUND: There is a paucity of reporting on recurrence patterns of de-novo sinonasal squamous cell carcinoma (DN-SCC) and inverted-papilloma-transformed sinonasal squamous cell carcinoma (IP-SCC). METHOD: A systematic literature review queried studies comparing recurrence patterns in patients with both DN-SCC and IP-SCC. Primary outcomes included local and regional recurrence and rates of distant metastasis. Of the 595 studies screened, eight were included. RESULTS: Patients with DN-SCC had significantly higher rates of positive margins, advanced T classification (T3/T4), treatment with chemotherapy and radiotherapy. There were no significant differences in local recurrence or regional recurrence. Overall risk of distant metastasis was lower in IP-SCC. DN-SCC, compared to IP-SCC, is more likely to present with advanced TNM classification and have positive margins after surgical resection, which may affect rates of distant metastasis and recurrence. CONCLUSIONS: The findings in this study suggest IP-SCC may be a less aggressive malignancy compared to DN-SCC, with the possibility of a reduced role for adjuvant therapy in IP-SCC. Further studies are required to better understand differences in tumor biology and treatments strategies between IP-SCC and DN-SCC.
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Carcinoma de Células Escamosas , Neoplasias Nasais , Papiloma Invertido , Neoplasias dos Seios Paranasais , Humanos , Papiloma Invertido/cirurgia , Carcinoma de Células Escamosas/terapia , Carcinoma de Células Escamosas/patologia , Neoplasias dos Seios Paranasais/cirurgia , Estadiamento de Neoplasias , Estudos Retrospectivos , Neoplasias Nasais/terapia , Neoplasias Nasais/patologiaRESUMO
1. Two experiments were conducted to investigate whether the use of phytase in the pre-experimental or experimental phases of true pre-caecal phosphorus digestibility (TPD) assay influenced the assayed TPD values. In experiments 1 and 2, broiler chickens were randomly allocated to 12 treatments in a 2 × 2 × 3 factorial arrangement. The factors were pre-experimental phytase supplementation (+ or -), experimental phase phytase supplementation (+ or -) with varying soybean meal inclusion levels (450, 560, or 670 g/kg).2. The diets in the pre-experimental phase were based on maize-soybean meal, whereas the diet used during the experimental phase was semi-purified, with soybean meal as the only source of P. Both TPD and true phosphorus retention (TPR) were determined using regression for the P output (g/kg, dry matter basis), pre-caecal or total tract, against P intake (g/kg). Data for TPD and TPR were analysed as a 2 × 2 factorial (with or without pre-experimental or experimental phase phytase).3. In both experiments 1 and 2, there were no significant effects for pre-experimental phytase supplementation nor interaction of pre- and experimental phytase supplementation on any of the pre-caecal digestibility responses. Phytase supplementation during the experimental phase increased (P < 0.01) pre-caecal P digestibility and retention, as well as digestible and retained P intake, and decreased (P < 0.01) P output.4. In experiment 1, pre- and experimental phytase supplementation increased (P < 0.01) the coefficient of TPR. In experiment 2, there was no significant effect of pre-experimental phytase supplementation on coefficient of pre-caecal TPD. However, phytase supplementation in the experimental phase increased (P < 0.01) the coefficient of pre-caecal TPD.5. In conclusion, whether or not phytase was supplemented to a P-adequate diet in the pre-experimental phase of the TPD assay, it had no influence on assayed TPD or TPR value.
Assuntos
6-Fitase , Fósforo na Dieta , Animais , Fósforo , Ração Animal/análise , Digestão , Galinhas/fisiologia , Dieta/veterinária , Suplementos Nutricionais , Glycine maxRESUMO
RESUMEN Introducción: El rendimiento académico universitario puede verse afectado por diversos factores personales y ambientales. Objetivo: Determinar los factores asociados al rendimiento académico en estudiantes de medicina de una universidad peruana. Métodos: Estudio transversal realizado en 247 estudiantes del primer al noveno ciclo. Se recopiló las calificaciones de la asignatura con el mayor número de créditos y se aplicó una encuesta para recolectar datos sobre sexo, estado civil, carrera previa, estado laboral y nivel de ansiedad. Se realizó un análisis de regresión simple y múltiple para estimar la asociación entre el rendimiento académico y las variables sociodemográficas de los encuestados. Resultados: El 70 % fueron mujeres, la mediana de edad fue 21 años. El 79,4 % reportó haber culminado una carrera. Casi la cuarta parte reportó tener una actividad laboral (24,3 %). El 46,2 % de universitarios presentó ansiedad. La mediana de nota obtenida fue 16 puntos. En el análisis de regresión simple se encontró que haber realizado una carrera previa (p= 0,044) y tener actividad laboral (p= 0,038) estuvieron asociados positivamente al puntaje de rendimiento académico. Sin embargo, en el análisis de regresión múltiple, no se mantuvo las diferencias observadas en ambas variables (p> 0,05). Conclusión: La mediana de nota en el período de estudio es 16 puntos. La mayoría tiene carrera previa y casi un tercio se encuentra laborando. La prevalencia de ansiedad es importante. Sin embargo, no se observa una asociación estadísticamente significativa entre los factores estudiados y el rendimiento académico.
ABSTRACT Introduction: University academic performance can be affected by various personal and environmental factors. Objective: To determine the factors associated with academic performance in medical students at a Peruvian university. Methods: Cross-sectional study conducted in 247 students from the first to the ninth cycle. The grades of the subject with the highest number of credits were collected and a survey was applied to collect data on sex, marital status, previous career, work status, and anxiety level. A simple and multiple regression analysis was performed to estimate the association between academic performance and sociodemographic variables of the respondents. Results: 70 % were female, median age was 21 years. Seventy-nine-point four percent reported having completed a career. Almost a quarter reported having a job (24,3 %). Anxiety was reported by 46,2 % of university students. The median grade obtained was 16 points. In the simple regression analysis, it was found that having a previous career (p= 0,044) and having a job (p= 0,038) were positively associated with the academic performance score. However, in the multiple regression analysis, the differences observed in both variables were not maintained (p> 0,05). Conclusion: The median grade in the study period is 16 points. Most of them have a previous career and almost a third are working. The prevalence of anxiety is significant. However, there is no statistically significant association between the factors studied and academic performance.
RESUMO
Wild Callery pear (Pyrus calleryana Decne.) results from a cross between various cultivars of P. calleryana and any other Pyrus individual. While many cultivars of this species are still commercially produced and sold for horticultural purposes in the United States, Callery pear is a detrimental invasive species that encroaches on many managed and natural areas, damages equipment and injures people, pets, and livestock with its thorny branches, and likely causes detrimental ecological impacts. Despite its importance as an invasive species, the mechanisms behind Callery pear's invasion and spread are unclear. To identify potential drivers of invasion, we quantified feeding of generalist and specialist herbivores on Callery pear and four native tree species, based on insect host ranges, with choice and no-choice experiments followed by field surveys of herbivory on these same tree species. Feeding by all herbivores was lower on Callery pear than on native tree species in no-choice assays. Specifically, feeding on Callery pear was moderate by generalists and very low by specialists. Specialist feeding on Callery pear was comparable to native species in choice assays but was significantly reduced in no-choice assays. Reduced specialist feeding along with moderate generalist feeding on Callery pear in the field provides evidence for the Enemy Release Hypothesis as a potential driving mechanism behind its invasion success.
Assuntos
Pyrus , Rosaceae , Rosales , Animais , Herbivoria , Humanos , Espécies IntroduzidasRESUMO
RESUMEN Introducción: El personal sanitario representa la primera respuesta del sistema de salud en la pandemia de la COVID-19, por ello, es importante valorar su conocimiento sobre la identificación y atención de pacientes con la COVID-19. Objetivo: Identificar los factores asociados a la percepción del conocimiento de médicos residentes ante la atención de pacientes con la COVID-19 y describir la percepción de la salud mental durante la pandemia de la COVID-19. Métodos: Estudio transversal, realizado en 2020 en hospitales del Perú. Se empleó la escala "Perception of Knowledge in Health Workers" (alpha de Cronbach: 0,77). También, se empleó la escala "Mental Health COVID-19" (alpha de Cronbach: 0,88). Se realizó estadística bivariada y multivariada. Resultados: De los 200 encuestados, el 12 % y 5 % manifestaron que eran capaces de reconocer a un caso sospechoso y atender un paciente diagnosticado, respectivamente. El 41 % y 35 % estuvo muy de acuerdo con el miedo/preocupación de contagiar a su familia y sentir el maltrato por los pocos equipos de protección personal, respectivamente. En el análisis multivariado, la percepción del conocimiento se asoció a trabajar en emergencias (p= 0,007), a la cantidad de amistades positivos a la COVID-19 (p= 0,012) y a realizar recientemente una intubación (p= 0,035); estas fueron ajustadas por el puntaje de la percepción de salud mental. Conclusiones: Trabajar en emergencias, haber tenido contacto con pacientes contagiados y haber realizado procedimientos médico-quirúrgicos influyen en la percepción de conocimientos de los médicos sobre la atención de pacientes con la COVID-19.
ABSTRACT Introduction: Health personnel represent the first response of the health system in the COVID-19 pandemic. Therefore, it is important to assess their knowledge about the identification and care of patients with COVID-19. Objective: To identify the factors associated with the perception of knowledge of Peruvian resident physicians regarding the care of patients with COVID-19 and to describe the perception of mental health during the COVID-19 pandemic. Methods: Cross-sectional study, carried out in 2020 in hospitals in Peru. The "Perception of Knowledge in Health Workers" scale was used (Cronbach's Alpha: 0.77). And also, the "Mental Health COVID-19" scale was used (Cronbach's Alpha: 0.88). Bivariate and multivariate statistics were performed. Results: Of the 200 respondents, 12% and 5% stated that they were able to recognize a suspected case and care for a diagnosed patient, respectively; 41% and 35% strongly agreed with the fear/concern of infecting their family and feeling mistreatment due to the lack of personal protective equipment, respectively. In the multivariate analysis, the perception of knowledge was associated with working in emergencies (p= 0.007), with the number of positive friends for COVID-19 (p= 0.012) and with having recently undergone intubation (p= 0.035); these were adjusted by the mental health perception score. Conclusions: Working in emergencies, having had contact with infected patients and having performed medical-surgical procedures influence the perception of knowledge of doctors about the care of patients with COVID-19.